BASIC (08-94)

GN 01726.010 How to Develop and Process Applications Filed in the Foreign Service Post (FSP)

A. Introduction

The FSPs in Dublin take claims from individuals who wish to file for benefits under the Dutch agreement. The FSP in Dublin is specifically responsible for processing claims filed with the Dutch social security agencies. (See GN 01726.015)

When taking applications under the agreement, the FSP should follow the same general procedures and obtain the same applications and evidence as SSA field offices (See GN 01702.001 - GN 01702.525 for FO and FSP development and GN 01725.205 - GN 01725.215 for specific evidence and application requirements for the agreement with the Netherlands).

B. Procedure

Follow the procedure below which describes special development and routing instructions that apply to claims under the agreement filed in the FSP.

1. U.S. Claim

  • Obtain form SSA-2490-F4, Application for Benefits Under a U.S. International Social Security Agreement (Part I) and the appropriate RSDI applications.

  • Forward a liaison form SSA-2960-NL to the Sociale Verzkeringsbank (SVB) or Uitvoeringsinstituut Werknemers Verzekeringen (UWV) to request a Dutch coverage record if it appears the worker is not insured based on U.S. coverage alone. (See GN 01726.025 to detemine the proper agency.)

  • Forward the claim to DIO, and include the file and follow-up copies of the liaison form sent to SVB or UWV.

2. Dutch Claim

  • Take a protective statement on form SSA-795 (Statement of Claimant or Other Person) indicating a desire to file for Dutch benefits and send it to SVB or UWV under cover of form SSA-2960-NL.

  • Inform the claimant that SVB or UWV will contact him/her directly to complete the required Dutch applications.

3. U.S. and Dutch Claim

  • Obtain form SSA-2490-F4 (Parts I & II) and the appropriate RSDI applications.

  • Forward a liaison form SSA-2960-NL to SVB or UWV to request a Dutch coverage record (if it appears the worker is not insured based on U.S. coverage alone) and to certify the protective filing date.

  • Forward the claim to DIO, and include the file and
    follow-up copies of the liaison form sent to SVB/UWV.

  • Inform the claimant that SVB or UWV will contact him/her directly to complete the required Dutch applications.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201726010
GN 01726.010 - How